Drug Testing Reference
Tables for Drug Courts
TABLE I.
Specimen Detection
Period
Advantages
Disadvantages
URINE Provides a profile of both current and recent past substance usage - detection time generally calculated in days for most drugs (excluding alcohol). See Table IV that outlines additional detection window
estimates.
• provides detection for both recent and past usage
• sample is generally available in large quantities for testing
• drug & metabolites are highly concentrated therefore easily detectable using both laboratory-based & on-site testing devices • numerous inexpensive testing options including on-site testing
• uniform forensic criteria supported by years of court/legal case law & adjudication • established cutoffs
• invasive “witnessed” collection procedures required– necessitates same gender observed collections • specimen is susceptible to tampering via dilution/adulteration
• drug concentration influenced by fluid intake, savvy clients may consume copious fluids to alter testing results • sample collection process can be time consuming
• urine drug levels provide no interpretive data (no dose/concentration relationship) SWEAT (patch) Measures current (on-going) drug
use following patch application; past exposure not detected - patch is FDA approved to be worn for up to 7 days
• ability to monitor 24/7 for extended periods which provides a significant adjunct to the therapeutic process
• relatively client tamper-proof
• use has participant acceptability due to non-invasive approach
• increased deterrent to drug use • cross-gender collections
• cannot detect prior drug exposure • limited collection devices & testing laboratories
• potential risk of contamination during patch application/ removal
• limited number of drugs detected • no on-site testing
ORAL FLUID (saliva)
Provides recent usage detection - many drugs cannot be detected beyond 24 hours after use
• non-invasive, cross-gender collections • specimen tampering reduced
• data may relate to behavior/performance • on-site testing available (but not
recommended)
• short detection window
• specimen collection can be time consuming
• limited collection devices & testing facilities
• cutoffs not well established • limited number of drugs detected • on-site testing devices pose forensic concerns regarding accuracy & reliability
TABLE I. (continued)
Specimen Detection
Period
Advantages
Disadvantages
HAIR Provides past drug usage only -
detection period up to 90 days - does not provide recent drug use information (hair required to grow out of scalp prior to sample acquisition)
• extended detection period
• non-invasive, cross-gender sample collection
• reduced specimen tampering • no bio-hazard issues
• no poppy seed interference
• increased cost per sample tested • inability to detect recent drug usage • limited number of testing facilities • no on-site testing
• continuing concerns regarding ethnic, hair color bias
• use of “body” hair forensically controversial
• testing may not detect single drug use event
• date of drug use cannot be assessed
BLOOD Detects very recent usage of
abused substances - detection time often measured in hours following use
• results both qualitative and quantitative - may provide behavior/performance data in select circumstances (DUID)
• specimen tampering eliminated
• invasive sample collection - venipuncture required by medical staff
• no on-site testing
• traditional urine testing methods not applicable to blood analysis
• limited sample volume can be obtained • detection of abused drugs in blood difficult for many laboratories due to low levels of drug
• high potential for false negative results • specimen not recommended for drug court abstinence monitoring EYE SCANNING/
PUPILOMETER instruments
Designed to determine impairment, recent use monitoring client only - detection time measured in hours
• no specimen collection
• on-site devices, immediate results • ease of operation
• monitors impairment rather than abstinence
• short detection window
• may require additional specimen collections to confirm positives • not peer-reviewed
• devices may detect client fatigue as “positive”
TABLE II.
Type Advantages
Disadvantages
ON-SITE DRUG TESTING
• provides rapid result turn-around time (quick reward for drug free behavior/quick justification for
sanctions)
• ease of use technology
• potential for reduced testing costs • no capital equipment expenditures • reduced training costs
• elimination of specimen transport and storage issues
• increased cross-reactivity and interference (potential false positive results)
• on-site testing often does not include quality control • on-site testing often does not
include testing for diluted samples (creatinine) and adulteration testing • testing personnel competency is
often not assessed
• reduced flexibility in testing panels (limited number of drugs tested) • potential privacy/conflict of interest concerns
LABORATORY-BASED DRUG TESTING
• tested often provided by
professionally trained technologists • use of approved scientific methods • integrated quality assurance • confirmation testing more readily available
• creatinine and adulteration testing more readily available
• toxicology expertise/forensic competency
• established custody and control procedures
• increased result turn-around time (compared to on-site testing) • additional sample handling and
shipment required
• potential increased cost per test • difficulty in accessing data and
information from large corporate laboratories
TABLE III.
Drug Screening
Cutoffs
Confirmation
Cutoffs
in ng/mL in ng/mL AMPHETAMINES 500 or 1000 500 BARBITURATES 200 or 300 100 - 300 BENZODIAZEPINES 200 or 300 100 - 300 CANNABINOIDS 20 - 50 15 COCAINE METABOLITE 150 or 300 150 OPIATES ** 300 100 - 300 PHENCYCLIDINE (PCP) 25 25 ALCOHOL variable 10 mg/dL
** The federal opiates cutoff level of 2000 ng/mL is not recommended for abstinence monitoring programs. Consult your laboratory or on-site vendor to ensure appropriate opiates cutoff is being used.
TABLE IV.
Drug
Approximate Drug Times in Urine
AMPHETAMINES 1 - 4 days
BARBITURATES 1 - 7 days
BENZODIAZEPINES 1 - 7 days
CANNABINOIDS ** Detailed cannabinoid detection
information available in NDCI Fact Sheet - Volume IV, Issue
2, April 2006
at 50 ng/mL cutoff:
up to 3 days for single event/occasional use up to 10 days for heavy chronic use
at 20 ng/mL cutoff:
up to 7 days for single event/occasional use up to 21 days for heavy chronic use
COCAINE METABOLITE 1 - 3 days
OPIATES 1 - 4 days
PHENCYCLIDINE (PCP) 1 - 6 days
ALCOHOL (as ethyl alcohol) ---
as alcohol metabolites EtG/EtS
variable, usually measured in hours ---
at the 500/100 ng/mL cutoff: 24-48 hours
**
NOTE: The only timeframe in which an individual’s chronic marijuana use (possibly leading to extended cannabinoids elimination) is relevant is during a client’s admission into the drug court program. Following the initial detoxification phase, the extent of a client’s past chronic marijuana usage does not influence the cannabinoid detection window as long as appropriate supervision and drug monitoring for abstinence continues on a regular basis. Therefore, the consequences of chronic marijuana usage on cannabinoid detection are effectively limited to the initial entry phase of the program.TABLE V.
Type
Method Description
Control Strategy
PRE-COLLECTION
DILUTION
Consumption of large volumes of fluid just prior to sample collection in an effort to dilute urine drug
concentrations to below the screening test cutoff - thus producing false negative results. (flushing, water loading, hydrating)
Perform creatinine levels on all drug court samples to assess specimen validity. Samples with creatinine concentrations of less than 20 mg/dL are generally considered dilute and test results do not accurately reflect a client’s drug use history.
POST-COLLECTION
DILUTION
Addition of liquid (water, colored fluid) to sample post collection in an effort to dilute urine drug
concentrations to below the screening test cutoff - thus producing false negative results.
Direct observation/witnessed
collection should preclude most post-collection dilution – in addition to determining creatinine levels.
ADULTERATION Addition of chemical agents (liquids or powders) to sample (post-collection) designed to disrupt testing procedures or to mask the presence of drugs.
Specimen validity testing (SVT). Specialized tests capable of detected chemical adulteration agents. Available from most drug testing labs - on-site “instant” SVT devices are also available. SUBSTITUTION Replacing client urine sample with a
substitute “look-a-like” sample – biological substitution (another person’s “clean” urine OR non-biological substitution (replacing urine with apple juice, Mountain Dew, water with food coloring)
Use of specimen validity testing (SVT) combined with creatinine testing - most non-biological samples will result in minimal creatinine concentrations.
Specimen validity tests (SVT) are specialized analyses designed to identify chemical substances the presence of which are inconsistent with normal human urine.
